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The role of interim FDG PET-CT after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer

PURPOSE: Induction chemotherapy (ICT) with docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by concurrent chemoradiotherapy (CCRT) has the advantages of organ preservation and systemic control in head and neck cancer (HNC). Early prediction of CCRT efficacy may help identify patients who will...

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Autores principales: Kim, Ka-Rham, Shim, Hyun-Jeong, Hwang, Jun-Eul, Cho, Sang-Hee, Chung, Ik-Joo, Park, Ki Seong, Kang, Sae-Ryung, Kwon, Seong Young, Chung, Woong-Ki, Bae, Woo Kyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745569/
https://www.ncbi.nlm.nih.gov/pubmed/28940101
http://dx.doi.org/10.1007/s00259-017-3836-8
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author Kim, Ka-Rham
Shim, Hyun-Jeong
Hwang, Jun-Eul
Cho, Sang-Hee
Chung, Ik-Joo
Park, Ki Seong
Kang, Sae-Ryung
Kwon, Seong Young
Chung, Woong-Ki
Bae, Woo Kyun
author_facet Kim, Ka-Rham
Shim, Hyun-Jeong
Hwang, Jun-Eul
Cho, Sang-Hee
Chung, Ik-Joo
Park, Ki Seong
Kang, Sae-Ryung
Kwon, Seong Young
Chung, Woong-Ki
Bae, Woo Kyun
author_sort Kim, Ka-Rham
collection PubMed
description PURPOSE: Induction chemotherapy (ICT) with docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by concurrent chemoradiotherapy (CCRT) has the advantages of organ preservation and systemic control in head and neck cancer (HNC). Early prediction of CCRT efficacy may help identify patients who will benefit more from surgery than from CCRT. We investigated the role of interim 18-fluoro-2-deoxy-glucose positron emission tomography computed tomography (FDG PET-CT) after ICT to predict the efficacy of CCRT and clinical outcomes. METHODS: Tumor responses were retrospectively reviewed after CCRT based on the Response Evaluation Criteria in Solid Tumors. FDG PET-CT imaging was performed before and after three cycles of TPF. We examined the associations between the metabolic response (percentage decrease in the maximum standardized uptake value [SUVmax] and total metabolic tumor volume [MTV]) after ICT and complete response (CR) to CCRT, progression-free survival (PFS), and overall survival (OS). RESULTS: We studied 43 HNC patients with a median follow-up of 32.7 months. Lymph node (LN) SUVmax and total MTV decreases from baseline after ICT were greater in patients with a CR to CCRT than in non-CR patients (LN SUVmax, 88.8% vs. 62.5%, respectively; total MTV, 99.7% vs. 89.9%, respectively). Decreases in total MTV ≥ 78% and LN SUVmax ≥73% after ICT predicted CR to CCRT and longer OS and PFS. CONCLUSIONS: Using interim FDG PET-CT to measure SUVmax and total MTV after three cycles of ICT may be a useful technique for identifying HNC patients who will benefit from CCRT and predicting survival outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00259-017-3836-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-57455692018-01-08 The role of interim FDG PET-CT after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer Kim, Ka-Rham Shim, Hyun-Jeong Hwang, Jun-Eul Cho, Sang-Hee Chung, Ik-Joo Park, Ki Seong Kang, Sae-Ryung Kwon, Seong Young Chung, Woong-Ki Bae, Woo Kyun Eur J Nucl Med Mol Imaging Original Article PURPOSE: Induction chemotherapy (ICT) with docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by concurrent chemoradiotherapy (CCRT) has the advantages of organ preservation and systemic control in head and neck cancer (HNC). Early prediction of CCRT efficacy may help identify patients who will benefit more from surgery than from CCRT. We investigated the role of interim 18-fluoro-2-deoxy-glucose positron emission tomography computed tomography (FDG PET-CT) after ICT to predict the efficacy of CCRT and clinical outcomes. METHODS: Tumor responses were retrospectively reviewed after CCRT based on the Response Evaluation Criteria in Solid Tumors. FDG PET-CT imaging was performed before and after three cycles of TPF. We examined the associations between the metabolic response (percentage decrease in the maximum standardized uptake value [SUVmax] and total metabolic tumor volume [MTV]) after ICT and complete response (CR) to CCRT, progression-free survival (PFS), and overall survival (OS). RESULTS: We studied 43 HNC patients with a median follow-up of 32.7 months. Lymph node (LN) SUVmax and total MTV decreases from baseline after ICT were greater in patients with a CR to CCRT than in non-CR patients (LN SUVmax, 88.8% vs. 62.5%, respectively; total MTV, 99.7% vs. 89.9%, respectively). Decreases in total MTV ≥ 78% and LN SUVmax ≥73% after ICT predicted CR to CCRT and longer OS and PFS. CONCLUSIONS: Using interim FDG PET-CT to measure SUVmax and total MTV after three cycles of ICT may be a useful technique for identifying HNC patients who will benefit from CCRT and predicting survival outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00259-017-3836-8) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2017-09-22 2018 /pmc/articles/PMC5745569/ /pubmed/28940101 http://dx.doi.org/10.1007/s00259-017-3836-8 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Kim, Ka-Rham
Shim, Hyun-Jeong
Hwang, Jun-Eul
Cho, Sang-Hee
Chung, Ik-Joo
Park, Ki Seong
Kang, Sae-Ryung
Kwon, Seong Young
Chung, Woong-Ki
Bae, Woo Kyun
The role of interim FDG PET-CT after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer
title The role of interim FDG PET-CT after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer
title_full The role of interim FDG PET-CT after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer
title_fullStr The role of interim FDG PET-CT after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer
title_full_unstemmed The role of interim FDG PET-CT after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer
title_short The role of interim FDG PET-CT after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer
title_sort role of interim fdg pet-ct after induction chemotherapy as a predictor of concurrent chemoradiotherapy efficacy and prognosis for head and neck cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745569/
https://www.ncbi.nlm.nih.gov/pubmed/28940101
http://dx.doi.org/10.1007/s00259-017-3836-8
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